I'm trying to track down a source of phenobarb in a credible-sounding, panicked middle-aged woman. Shults MRO Handbook 2009 says phenobarb can be found in OTC products. Specifically:
There are over-the-counter preparations that contain phenobarbital. Examples are Donnagel*, Primatene* tablets, Bronkotabs* and Bronkolixir*. This is also labeled as "barbituric acid." ....
The fact that phenobarbital is available in a number of common over-the-counter medications makes it imperative that the laboratory identify the parent drug. Unless the laboratory has identified a specific and exclusive Schedule II compound such as secobarbital, caution should be used in reporting positive results.
I noticed that in a prior discussion on this forum (2011) there is no mention of OTC sources of phenobarb, but as shown above, Shults states clearly that this is a problem.
Is Shults incorrect?
- (Dr) Rick
Robert Swotinsky MD
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Mr. Shult's book references Donnagel, Primatene, Bronkotabs, and Brnkolixir as over the counter products that contain phenobarbital. My understanding is that FDA removed these products from the market some years ago. For example, see:
http://www.upi.com/Archives/1988/08/24/ ... 588398400/
The donor who provided the phenobarbital-positive urine and has no explanation may have taken phenobarbital as a prescribed drug, may have gotten hold of one of the products listed above (though they should be pretty old by now), or may have submitted urine that wasn't her own and it happened to be from someone who took phenobarbital. It seems unlikely the donor was using phenobarbital recreationally, since this is not a drug commonly abused in that way.
thanks very much, Dr. Swotinsky.
I have encountered couple of donors tested positive for Phenobarb who were taking Donnatal, which is still on the market. It is frequently prescribed by GI docs, and most donors don't even think about it, they usually declare meds given by Primary care, and forget about this. I had to prompt them to get the information, and they ended being legitimate on this medication.